Cover Story, Part 2: Factors to Consider When Getting Insurance

A trip to the doctor isn’t cheap, especially to an international hospital. Healthcare costs can be a nightmare to settle if you’re uninsured. So here are some of the factors to consider when getting insurance.

Emergency coverage – including inpatient and emergency evacuation – is perhaps the most important benefit for families. Other considerations include vaccination coverage, outpatient coverage, annual health check coverage, and the hospitals covered by the plan. Here’s a quick rundown:

Annual Limit
An annual limit is a cap on benefits that your insurer will pay in a year. If the dollar amount of covered hospitalizations, treatments, and prescriptions exceeds the annual limit, you’ll need to pay all healthcare costs for the rest of the year. Annual limits range from USD 100,000 to several million per year depending on the plan. The higher the limit, the more expensive the premium.

Annual Rate Increases
Smaller and mid-range insurers with less financial stability usually have more erratic rate increases. Some even increase the premium in response to claims. Larger, more reputable insurers have more gradual increases, both annually and with age.

Child Coverage
Medical care for children (including checkups and immunizations) is often included, but confirm this with your insurer. Families with older children who may or may not live at home as dependents may be included, but check if there are any age caps and details of the “global” part of “global insurance coverage” if your kids don’t live in China.

Discounts
Some insurers offer a family discount, which can be especially cost-effective for large families. No-claims discounts or first-year discounts are sometimes also offered, but keep in mind that a 10 percent first-year discount carries a 10% + age + annual increase at renewal.

Maternity Coverage
Couples planning to conceive should note that most insurers require a waiting period of 10-12 months of paid maternity insurance before pregnancy, birth, and/or newborn coverage kick in.

Medical Evacuation
Evacuation is an essential consideration. Take a moment to think about the cost of out-of-pocket repatriation in case of an emergency. Evacuation would cover transport for essential surgery, medical treatments unavailable here, or a health epidemic. Check whether the plan covers return transportation to Beijing. Insurance for evacuation can be overkill if your primary policy covers most or all possibilities, so make sure it complements rather than overlaps existing coverage. Note that medical evacuation doesn’t necessarily cover treatment in your home country or a third location like Hong Kong.

Outpatient Treatment
Consider how often you or your dependents are likely to visit the doctor in a given year. Policies with high deductibles to minimize the cost of monthly premiums may not be the most cost-effective if you’re only planning to see a doctor twice a year.

Pre-Existing Conditions
Some insurers will cover certain pre-existing medical conditions, but the trade-off is a higher premium. Coverage for high blood pressure or cholesterol may seem expensive, but keep in mind you’d also be covered for heart attacks.

Travel Insurance
International travel goes hand-in-hand with living in Beijing; getting travel insurance is important as a backup on your rider. This is often available as a small package when you have visitors, either through your current insurance plan or through an international hospital or clinic membership. US citizens should note that many global policies don’t cover treatment in the US or only cover it for a limited number of days (usually 30-45).

Others
Additional considerations include coverage for children with special needs, deductible and copayment options, dental and visual insurance, coverage for second opinions on major treatments, and emergency protocols (e.g. whether pre-authorization is required).

In addition to health insurance, international hospitals as such Beijing United Family Hospital or primary care clinics such as Raffles Medical have memberships that offer patients additional discounts and extra services for an annual fee. These memberships can supplement company-sponsored insurance packages; they can also be appealing for expats who select packages based on low upfront fees, or those who must pay for treatment out-of-pocket.